# WILLOW CANYON HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pueblo Springs Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861916686
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 5545 E LEE ST, TUCSON, AZ 85712-4205
- **Practice address phone:** (520) 296-2306
- **Practice address fax:** (520) 296-4072
- **Mailing address:** 5545 E LEE ST, TUCSON, AZ 85712-4205
- **Mailing address phone:** (520) 296-2306
- **Mailing address fax:** (520) 296-4072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2017
- **Last updated:** 07/21/2022